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When is a hospital not a hospital? When it’s a new wing, specialist centre, or a major refit — and is needed to make up the number of the government’s “48 hospitals by the end of the decade” manifesto promise.

HSJ has revealed a communications “playbook” from the Department of Health and Social Care tells trusts major refurbishments and new wings/units which are part of its “new hospitals” scheme “must always be referred to as a new hospital”. 

The instructions for comms on the programme, dated this month, follows a running controversy over the description of the prominent Conservative manifesto commitment, with questions raised about how many new hospitals will be delivered in reality, and the fact many of those planned are not full hospital builds.

Last week, Sajid Javid was criticised for describing the excellent new Northern Centre for Cancer Care — which is part of the Cumberland Infirmary in Carlisle and the first of the 48 schemes to open — as a “new hospital”. Newcastle upon Tyne Hospitals Foundation Trust, which runs it, did not describe it as a hospital.

Several others among the 48 are new units or wings, or major refurbishments of existing sites, while some are community hospital rebuilds.

The document also encourages trusts to reiterate the 48 hospitals commitment, presumably to try to ram home the political win for the government from this as yet undelivered promise, and stressed press releases on the issue must be signed off by the DHSC — an issue reminiscent of the battles local NHS organisations are also still having with NHS England central comms sign off.

Tolerance limits

Whistleblowers at the Tees Esk and Wear Valleys Foundation Trust have raised a number of concerns over the past year.

They include claims a ward manager was “selling perfume” to vulnerable patients and “making a commission,” learning disability staff were taking home food meant for patients, and the trust was making “desperate” efforts to prove on paper that safe care was being provided “while patients and staff are suffering”.

TEWV CEO Brent Kilmurray has said some staff “are prepared to tolerate bad behaviour from others”. In an internal message to staff in August, seen by HSJ, Mr Kilmurray praised whistleblowers who highlighted concerns but said: “We sometimes have a poor track record in holding people to account.”

The concerns came amid a Care Quality Commission inspection of the trust’s leadership. In July, Mr Kilmurray told governors that the watchdog had raised concerns about staffing and escalation processes in forensic secure inpatient services.